Inspection on 18/04/05 for Elizabeth House

This inspection was carried out on 18th April 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Elizabeth House 04/09/07

Elizabeth House 06/10/06

Elizabeth House 10/10/05

Elizabeth House 26/08/04

Similar services:

Flint House

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

The Cotswold Home

Fairways

Treloar College

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 ELIZABETH HOUSE 14 Huckleberry Close Purley on Thames Reading RG8 8EH Lead Inspector Susan Cledwyn-Davies Unannounced 18 April 2005 9.55am The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. ELIZABETH HOUSE Version 1.10 Page 3 SERVICE INFORMATION Name of service Elizabeth House Address 14 Huckleberry Close, Purley on Thames, Reading, Berks, RG8 8EH Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0118 942 7608 0118 942 6671 Purley Park Trust Ltd Acting Manager Rachel Keeling Care Home 7 Category(ies) of Learning Dsability (7), Learning disability over registration, with number 65 years of age (7) of places ELIZABETH HOUSE Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: No Date of last inspection 26.8.2004 Brief Description of the Service: Elizabeth House is a one storey seven-bedded unit providing residential and day care support to adults with learning disabilities. The house provides care to residents with higher dependencies, and although nursing care isn’t provided. Each resident has their own personalised bedroom with en-suite shower rooms and toilets, with sanitary and bathing equipment adapted to their individual needs. There is an assisted bath, which is available to all residents. Elizabeth House is part of Purley Park Trust. Purley Park Trust has eight registered Homes, comprising of a variety of accommodation and support facilities. All of these homes are situated in Purley Park. All residents will have access to the grounds and other services provided by the Trust including, horticultural therapy, day services, social, recreational and leisure pursuits and the on site club house. Local facilities accessed include shoopping facilities and the local village including Church. ELIZABETH HOUSE Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place between 9.55am and 3pm. The inspection included a tour of the home, discussion with the acting manager, 5 residents and 3 staff. Six residents were living in the home; one resident was in hospital. The house was built last year and the residents moved from a large mansion house. A meeting was held prior to this visit to ask people living in this home the preferred title between service users, resident and client. The name resident was chosen and this term is therefore used throughout the report. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or ELIZABETH HOUSE Version 1.10 Page 6 by contacting your local CSCI office. ELIZABETH HOUSE Version 1.10 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection ELIZABETH HOUSE Version 1.10 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1 All residents have information about the home. EVIDENCE: All residents have a service user guide that they have seen which is stored with individual care plans. Residents knew about the home and could make decisions about their life in the home. ELIZABETH HOUSE Version 1.10 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 8 and 9 Residents needs are assessed and changing needs recognised. Residents are encouraged to make decisions and participate fully in the home. EVIDENCE: Residents care plans were up to date, 6 monthly reviews took place internally and annual reviews involving the resident, relatives and other relevant people took place. Care plans included risk assessments as necessary and these were reviewed annually as a minimum. Residents were involved in care planning and spoke of attending review meetings to put forward their views. One resident moved in last summer and has settled very well. Staff enabled the settling by using behaviour strategies discussed with the community nurse. Written strategies have still not been provided by the nurse for staff use, the inspector required that these be written by home staff in the interim to provide support for staff and to encourage continuity. One resident has asked for a key for the bedroom door and this is being obtained. ELIZABETH HOUSE Version 1.10 Page 10 The Manager and staff provide good care and residents are happy with the care. There were discussions with the Acting Manager that records could more fully reflect all the care given. Residents attend monthly house meetings minutes of which were seen. Residents confirmed that they were encouraged to make suggestions and that these were followed up. Next month one resident of Elizabeth house is marrying a resident of another house on the site. The wedding is arranged in the local church and the reception is being organised in the club room by staff. The resident spoke of all the support being given to her and appreciating this. ELIZABETH HOUSE Version 1.10 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13, 14, 15, 16 and 17 Residents take part in a variety of activities both on and off the site. The activities change according to choice and availability. Residents’ personal and family relationships are encouraged and supported. Some residents do not have a paid for 7 day holiday away from the home. EVIDENCE: Each resident has activities planned during the week including using the activities on site in the clubroom and horticultural area, as well as in local colleges and sports centres. A number of residents have started going to the local church for the Sunday morning service; this is enjoyed. Residents are encouraged able to visit other houses and the club room during the day, for social visits. On entering the site there is an active busy feel. Houses work together to promote residents choice. One resident in this house is going on holiday with residents from the next door house. As previously noted, one resident is shortly getting married and the acting manager and staff are helping with the arrangements. The League of Friends has now restarted with additional relatives support. ELIZABETH HOUSE Version 1.10 Page 12 Residents’ finance management and storage was not inspected. There is an outstanding recommendation that all residents have a 7 day paid holiday. All new residents have this sum included in their fees. For some existing residents who have lived in the home for many years then the proprietor continues to negotiate adequate fees for all service users. This remains as a recommendation. The meals provided have been reviewed with residents to ensure that their views are introduced. This menu is now prepared as a monthly menu which is repeated. The meal shared with residents during the visit was freshly prepared and fresh fruit and vegetables. A record of the meals consumed is now kept on the daily sheet for each resident. ELIZABETH HOUSE Version 1.10 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19 and 20 Residents’ personal care and healthcare needs were met. Medication practice and procedures were sound. EVIDENCE: Personal care is given in individual rooms. Residents spoke of and knew their individual key workers. These staff provided extra support and assistance to residents. Care plans showed that health advice from Doctors, nurses etc. was obtained as necessary. The medication storage was neat and tidy; records were up to date. Since the last inspection medication administration is now by 2 staff. One administering and a second witnessing. There is now a specific record of medication training given prior to staff administering medication. All staff have medication training annually. ELIZABETH HOUSE Version 1.10 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 Residents were listened to and protected from abuse, neglect and self-harm. EVIDENCE: There is a comprehensive complaints system. Residents have a user-friendly version that has been discussed with key workers. There is a complaints record; no complaints have been made. The staff training on protection of vulnerable adults from abuse takes place. House managers attend an external course and all remaining staff complete an internal training using a video and questionnaire with the manager. Staff spoke of having completed the course and being aware of the action to take if poor practice was suspected. The house has the most recent interagency guidelines. ELIZABETH HOUSE Version 1.10 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 26 and 30 Residents live in a good quality house that promotes their independence. EVIDENCE: The house was purpose built last year, is in good condition and well maintained. The inspector was advised that a second maintenance man has been employed to ensure that all work is completed. There is a problem with the en-suite showers leaking water into residents’ rooms. The proprietor is trying to resolve this with the builders. The house now looks and feels more like a home. Residents’ individual rooms reflect their own interests and tastes. Hoists and bathing aids are provided for residents with poor mobility. The house was clean, tidy, bright and fresh. ELIZABETH HOUSE Version 1.10 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33 and 35. There is an effective staff team that undertakes regular training and appropriate qualifications. EVIDENCE: There is sufficient staff to cover the home. The staffing levels are from Monday to Friday 3 care staff in the morning and 2 in the afternoon, plus one waking night staff. At the weekend there are 2 staff in the morning, 2 in the afternoon and one waking night staff at night. Residents spoke well of care staff, of the care given. The inspector observed good communication between staff and residents. NVQ training is considered important. Two staff have qualified in NVQ level 2, all the remaining staff are starting or in the process of completing level 2 or 3 as appropriate. Training records are now available in the house. A new central training record in being prepared using a computerised system and this is nearly in operation. Staff spoke of having had a number of training courses. ELIZABETH HOUSE Version 1.10 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 39, 40 and 42 A registered manager is needed to ensure the home provides the best care for residents. Residents’ views are considered. The home policies and procedures safeguard residents and the health and safety of residents is promoted. EVIDENCE: The registered manager left last year and Purley Park Trust has been trying to fill the post since then. The inspector was advised that 3 potential managers were recruited and that each one had to refuse the post for personal reasons. It is hoped that a recently found good candidate will be recruited for the post. An annual development plan has been prepared and was on display. The plan is for use by all staff, though recently introduced it had been updated already. Questionnaires to check the quality of care had been prepared for relatives and care managers. A set of 7 questionnaires had been prepared for residents on a variety of topics, the aim being to use as many or few as appropriate. A ELIZABETH HOUSE Version 1.10 Page 18 committee of managers and interested people had developed these questionnaires. The policies and procedures have been updated and 6 policies reviewed. The health and safety standard was partially inspected. Following the new build some of the servicing and final works are both with the builder and proprietor. It is planned that a file of servicing and maintenance records will be available. Fire safety was safeguarded and accident records showed appropriate response. There is a remaining requirement that all staff should receive challenging behaviour training. The Care manager has attended SKIP training but this has not been passed on to all staff due to lack of time and people to do the training. The requirement is therefore repeated with the comment that this training is important for staff competence and confidence. SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. Where there is no score against a standard it has not been looked at during this inspection. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 ELIZABETH HOUSE Score 3 x x x Standard No 22 23 ENVIRONMENT Version 1.10 Score 3 3 Page 19 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 4 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 4 x 3 x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 2 3 x x Standard No 31 32 33 34 35 36 Score x 3 3 x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 2 x 3 3 x 2 x ELIZABETH HOUSE Version 1.10 Page 20 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. 3. Standard 6 37 42 Regulation 12 8 18 Requirement Timescale for action 1.5.2005 That behaviour strategies used for one resident are written and reviewed. That an application for registered 1.8.05 manager is received. This is a repeated requirement. that all staff receive challenging 1.10.05 behaviour training. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 14 Good Practice Recommendations That the proprietor continues to negotiate adequate fees from all service users to have a 7 day holiday away from the home. ELIZABETH HOUSE Version 1.10 Page 21 Commission for Social Care Inspection 1015 Arlington Business Park Theale Berks RG7 4SA National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI ELIZABETH HOUSE Version 1.10 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!